Adra Etho

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

ADRA ETHO

Practice address

1201 W Frank Ave
Lufkin, TX 75904-3357

Phone

(936) 637-6415

NPI assigned

Jan 14, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Darwin Clark, MDNPI 1104883008

Title

President

Phone

(936) 637-6415

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Darwin K Clark, MD

  • Diagnostic Radiology Physician
  • Orlando, FL
  • NPI 1104883008
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200268800000",
    "number": "1265618953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10567 SAWMILL PKWY",
            "address_2": "SUITE 100",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430656667",
            "telephone_number": "614-210-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W FRANK AVE",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759043357",
            "telephone_number": "936-637-6415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADRA ETHO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DARWIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-637-6415",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Lufkin, TX
• Providers in Lufkin, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.